‫بسم ا) الرحمن الرحيم‬

‫ اتمنى لي ولكم التوفيق‬6‫او‬

‫ قد جمعتها من عدة ملفات‬.. ‫متحان هيئه التخصصات الطبيه لقسم النساء والتوليد‬6 ‫سئله‬6‫هذه بعض ا‬
(‫حتمل ان يكون هناك اخطاء‬V‫جتهاد في حلها )يعني من ا‬6‫وبعضها من القروب مع ا‬
‫اتمنى انكم تنبهوني وتعدلوها‬
‫ تنسوني من صالح الدعاء‬6 ‫واخيرا‬
^‫ء ام‬6‫ ا‬.. ‫اختكم‬

Least effectine barrier contraception

A.foam
B.condom
C.vaginal diaphragm
22 yrs old female with dysgerminoma. She wants to preserve her fertility.during
surgery you found that the tumor was grade(?) in the right ovary(I con not
remember if the tumor was limited to the right ovary or there was spread) .your
action:
a-hystrectomy with salpingo-oophrectomy
b-salpingo-oophrectomyofthe right ovary only then
radiation
c-radiation then right sidesalpingo-oophrectomy
d-radiation only
Most commone complication of c.s
A.bladder injury
B.endometritis?
C.DVT
D.aspiration pnemonia
A pregnant female develops lesions on the vulva and
vagina and she was diagnosed as genital herpes, what
should be included in her future health care?
a. Cesarian section should be done if the
lesions did not disappear before 2 weeks of
delivery date
b. Oral acyclovir to treat herpes
c. Termination of pregnancy because of the risk
of fetal malformations
d. Avoidance of sexual intercourse for 1 month
after the healing of the lesions

The correct answer is b??

​
HSV in pregnant treated by : oral acyclovir 400
mg TID for 5-7 days . if HSV was present at
time of labor : c – section
Salpingitis and PID on penicillin but not improve the
most likely organism is :
a. Chlamydia trachomatis
b. Neisseria gonorrhoeae
Pt. with salpingitis and there is swelling in pelvis in posterior fornex and it is fluctuant
m:
a. Colpotomy
b. Laproscopi

colpotomy, also known as a vaginotomy, is a procedure by which an incision is made in the

vagina.

Purpose: A colpotomy is performed either to visualize pelvic structures or to perform surgery

on the fallopian tubes or ovaries
62 female with –ve pap smear you should advice to repeat pap smear every:
A- 6m
b- 12m
c- 18m
d- no repeat
The correct answer is d
Screening pap smear:
1- starting at age 21 years or no more than 3
years after becoming sexually active. 2- women > 30
years who have three consecutive normal test screening ( 1 / 3yeasr). 3-
screening should be discontinue for women > 60-70 years who have had 3 or more normal
pap smear.
rd
Pregnant female(?)weeks (I remember that she was in the 3 trimester) with
mild abdominal pain and vaginal bleeding- the best for diagnosis:
a-examination
b-examination with US
c-examination with lab order for fibrin(or fibrinogen)
Scenario of old patient with severe uterine prolapse. Ox very weak levator ani
muscle. Management:
a-plication of puborectalis
b-bladder catheterization 2 weeks befor surgery
c-kegel exercise
Regarding GDM:

a. Screening for GDM at 24 t0 28 weeks

b. Diet control is always successful TTT
c. Screening at 8 weeks
female came with vulval irritation the doctor told her to stop using
bubble bath she stopped it but the irritation continues 0n examination
the vulva skin was waxy like and specked appearance the dx is
1- psoriasis
2- atopic dermitites
3- contact dermitits
4- lichen planus

Newborn baby had VSD andoperation was done at the age of 18 yrs old. The
propability of VSD in the current pregnancy is:
a-0.5%
b-2%
c-40%
d-???
***it was 3.5% in case of one child previously affected
and 4.5% with 2 children and 5% if mother its self has
congenital HD and 7% if father affected
female with history of Post partum Hge with failure of lactation .Now she has
amenorrhea and infertility.ttt:
a-dopamine
b-gonadotropins
c-clomide

****sheehan syndrom: Treatment involves estrogen and progesterone

hormone replacement therapy. These hormones must be taken at least until the
normal age of menopause. Thyroid and adrenal hormones must also be taken.
These will be needed for the rest of your life

Young female with menorrhagia. Her hystroscopy result is as shown in the

picture (picture showing endometrial polyp)
Management:
a-hystrectomy
b-Hystroscopic excition
*** if there is curettage select it
combinned pills conidered as
a-increase endometial carcinoma
b-contraindicated in diabetic patient
c-contraindicated if the patient is 40 yrs or more
d-decrease cancer ovary
The most common causes of precocious puberty:
d. Idiopathic
e. Functional ovary cysts
f. Ovary tumor
g. Brain tumor
h. Adenoma

Earlier sign of puberty in male is:

i. Appearance of pubic hair
j. Increase testicular size
k. Increase penis size
l. Increase prostate size

What is the risk of GDM on her life later:

m. DM type 1
n. DM type 2
o. Impaired fasting glucose
the most common symptom in placenta abruption is
a. Vaginal bleeding
b. Uterine tenderness
 c. Uterine contractions
d. Fetal distress

Female presented with vaginal discharge, itching, and

on microscope showed mycoleous cells and spores.
This medical condition is most likely to be associated
with:
a. TB
b. Diabetes
c. Rheumatoid Arthritis

Vaginal thrush is a common infection caused by a yeast

called Candida albicans. Vulvovaginal candidiasis is
usually secondary to overgrowth of normal flora
Candida species in the vagina. Conditions that interrupt
the balance of normal vaginal flora include: antibiotic
use, oral contraceptives, contraceptive devices, high
estrogen levels, and immunocompromised states such as
diabetes mellitus and HIV. Women are prone to vaginal
thrush between puberty and the menopause because,
under the influence of the hormone estrogen, the cells
lining the vagina produce a sugar and yeasts which
Candida albicans are attracted to. That is why thrush is
rare before puberty.

4 years old girl presented to er with sore throat and

seroangious vaginal discharge with no pain what is
most propable cause,
a. Candida
b. Foreign body
c. Chlamedia
d. Gonococci
e. streptococcus

❖ Pediatric vaginal discharge:

infectious vulvovaginitis: present with malodorous , -1
yellow green, most common caused by group A
streptococcus. ( may be present with sexual abus "STDs"
) 2-foreign body
3-
candidal infection: may associated with diabetes …
measure glucose. 4-Sarcoma botryoids
(rhabdomyosarcoma ): malignant lesion appearance of
"bunches of graps" within vagina
Trichomoniasis is classically have:
a. Clue cells
b. Greenish frothy discharge

Trichomoniasis is caused by the flagellated

protozoan Trichomonas vaginalis; it's the most
common curable sexually transmitted disease in
the world. It usually presents with frothy yellow-
green vaginal discharge, strong-unpleasant odor,
pain during urination and sexual intercourse
What is an absolute contraindication of OCP :
a. Hx of previous DVT
b. Ovarian ca
c. Breast ca
both hx of DVT and breast cancer are absolute ,
contraindication , but in hx DVT is more
accurate
OCP is proven to :
a. Decrease ovarian ca
b. Decrease endometrial ca
c. Increase breast ca
d. Increase risk of ectopic pregnancy
Contraceptive pill that contain estrogen increase risk
of:
a. Breast Ca
b. Ovary Ca
c. Cervical Ca
Pregnant lady 34 weeks of gestation presented by vaginal
bleeding , which of the following is relevant to ask about
:
A. Smoking .
B. Desire of future pregnancy .
C. The result of last pap smear .
D. Hx of vaginal irritation .

because smoking is an important risk factor for

antepartum he
Female patient is sure that she is pregnant for 2
months , on examination , the uterus is larger than
suspected , B-hcg is very high , the doctor diagnosed
her as having tumor which is chemo sensitive , what is
the diagnosis :
A. Ovarian cancer
B. Endometrial cancer .
C. Gestational trophoblastic .
Which of the following is true regarding infertility :
A. It is Failure to conceive withing 6 months . (1
year)
B. Male factor > female factors . (the reverse)
C. It could be due to high prolactin levels .
D. Rare to be due anovulotion . (common)
E. Only diagnosed by HSG . (need full lab &
imaging investigations)
32 years old female patient presented by irregular
menses , menses occurs every two months , on
examination every thing is normal , which of the
following is the LEAST important test to ask about
first :
A. CBC .
B. Pelvic US .
C. Coagulation profile .
D. DHES .
Acase of 28 week pregnant complain of pruritis with no skin lesion sever
symptoms
Elevated liver enzymes
Elavated direct billirubin
Normal indirect billirubin
This case will deliver at
34_35
37_38
39_40
40_41

CIN1 in 6 weeks pregnant patient

.conization at 1st trimester
.conization at 2 nd trimester
.continain pregnancy and manage postpartum
*** CIN1 checked after pp but if CIN3 do another coloposcopy after 6month
befor delivary
Highest theortically effective in contraception
A.condom
B.vaginal diaphragm
C.cervical cap
Androgen insensitivity sydrome:
X linked recessive
Ovarian cause of infertile couple
20%
25%
Old age pt with uterine prolapse and wide hiatus and weak levator
ani.how to manage?
A.pelvic floor excercise
B.local estrogen
Decreased prolactin level in
A.dopamine
B.serotinin
C.thiazide
Pregnant with upper respiratory tract infection.risk of devolping
unintended pregnancy
A.rifampicin
B.doxycycline
****Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of
conception,, as b drug is teratogenic so termination after that is essential
The most common cause of secondry dysmenorrhea
A.endometriosis
B.IUD
Pregnant female with doppler indicating fetus is anemic
A.repeat doppler after 1 week
B.repeat after 2 week
C.repeat after 3 week
Case of precauscious puperty.
Caudal brain image normal
Normal bone age
Wt commonest cause:
Idiopathic
Cerebellar
Obese patient have pco complaining of irregular infrequent vaginal
bleeding.most appropriate management
A.endometrial guided biopsy
B.endometrial thickness measurement
Intial dose of thyroxine in pregnant with hypothyroidism
A.0.5 mcg/kg
B.1.5 mcg/kg
C.2 mcg/ kg
D.2.5 mcg/kg
42 yrs woman nullipara wants to get pregnant came for prenatal
counseling , fsh , lh and all hormones were normal and she has no
complain
Your advice is :
Reassure her
IVF
IUI
Pt with gestational DM.she checked her glucose level four times per
day.she complaining that glucose level very high after breakfast even
after normal fasting glucose level.cause
A.eating heavy meals at night
B.increased induline resistance in the morning
The most common chromosomal anomalies in aborted fetus?
A.autosomal triosmy
B.triploidy
C.tetraploidy
Female complaining of regular cyclic abdominal pain.on examination
appearance of secondry sexual characters., there is normal hymen but
cannot completely indrntified the vagina.cause
A.cribtiform hymen
B.longitudinal vaginal septum
C.sptate vagina
D.transverse vaginsl septum
Girl with headache. PRL 435
Wt. Nxt to do
MRI
Dopamine agonist
Umbilical vien. Becomes
ligamentum teres

pic of laproscopy with bloody lesions on the

surface of the uterus seems to be
endometriosis, next to it a picture while treating
these lesions
Question is this procedure is done because of ?
Pelvic pain
Infection
****No need to do in asymptomatic
Obese patient with rabid progressive hirsutism
Fsh normal
Lh. Normal
Testosteron 500 lncreased
Bp bl.suger normal:
A.androgen secreting tumor
B.PCO
c.gonadal origin.
Fetal erythrobiotic organ:
a-kidneys
b- spleen
c-liver
d-lungs
In the early fetus, erythropoiesis takes place in the mesodermal cells of the yolk sac. By the
[3]
third or fourth month, erythropoiesis moves to the liver. After seven months, erythropoiesis
occurs in the bone marrow.

Pregnant patient came with neck swelling and

multiple nodular non-tender goiter the next
evaluation is:
a. Thyroid biopsy
b. Give anti-thyroid medication
c. Radiation Iodine
d. TSH & Free T4, or just follow up
Pregnant diagnosed with UTI. The safest antibiotic is:
a) Ciprofloxacin
b) Ampiciln
c) Tetracycline

With these MCQs , the correct answer is b , but

if present nitrofurantion is more accurate
answer . UTI in pregnancy treated by :
nitrofurantion or cephalosporine ( 3– 7 days
) in symptomatic or asymptomatic UTI . avoid
fluroroquinolone ( which include :
ciprofloxacin, gatifloxacine, levofloxacin,
.( norfloxacin
86)Pregnant on 36 week came with 7 cm cervical
th

width at 0 station. During birth, CTG shows late

deceleration, management is:
d) Give Oxytocin
e) O2 and change mother position
f) Give Mg sulfate

Type of Etiology Management

 deceleration
Early Head compression No treatment
from uterine
contraction (normal
)
Late Uteroplacenta • Place patient on side
insufficiency and • Discontinue oxytocin.
fetal hypoxima • Correct any hypotension
• IV hydration.
• If decelerations are associated with tachysystole
consider terbutaline 0.25 mg SC
• Administer O2
• If late decelerations persist for more than 30 minutes
despite the above maneuvers, fetal scalp pH is
indicated.
• Scalp pH > 7.25 is reassuring, pH 7.2-7.25 may be
repeated in 30 minutes.
• Deliver for pH < 7.2 or minimal baseline variability
with late or prolonged decelerations and inability to
obtain fetal scalp pH

Variable Umbilical cord • Change position to where FHR pattern is

compression most improved. Trendelenburg may be
helpful.
• Discontinue oxytocin.
• Check for cord prolapse or imminent delivery
by vaginal exam.
• Consider amnioinfusion
• • Administer 100% O2

41 weeks pregnant lady last biophysical profile

showed oligohydroamnios. She has no complaints
except mild HTN. What is the appropriate
management :
a) Wait
b) Induce labor post 42 wks
c) Induce labor
d) Do biophysical profile twice weekly

A post transvaginal hysterectomy having vaginal urine dripping

during micturition Dx:
• vesicovaginal fistula.
• urethrovaginal fistula.
• ureterovaginal fistula.

Causative organism of toxic shock syndrome

staph

Case with increased velocity inMCA doppler.36 wks complaining of

decreased fetal movement for 2 days.what appropriate management
A.repeat doppler in 1 week
B.delivery
C.repeat dopplerin2 wks

Best diagnostic test for post menopausal bone density

1.MRI
2.Dual EXA

female 18 month infertilty

laparscopy gun shot lesion+adhesionin ovarian fossa after ablasion
timed ilntercourse
iui
ivf
clomid

38 weeks patient with come to emegency room complaining of mild

vaginal bleeding the fetus vertex with ‫ معاها صوره فيها‬sinusoidal
rhythm
Immediate c.s.
Repeat ctg
Fetal blood ph

Lateral vulvar growth 1.5 cm in 70 years old pt. Without lymph node
metadtasis
.Wide local excision
.Radical vulvectomy with1.5 cm sfety with epsilateral inguino femoral lymphadenectomy
.radical vulvectomy with 0.5 cm free margin with epsilateral inguinofemoral
lymphadenectomy
Local excision with epsilateral inguinofemoral lymphadenectomy.

70 yrs old
Presented with post menopausal bleeding cervix healthy
Most likely cause :
atrophic vaginitis

*** atrophic vaginitis most common cause 63%

Postmenopausal lady with lichen sclerosus

What is the treatment
clobetasol 0.05%

*** clobetasol is topical corticosteroid

18 yrs old Presented with amenorrhea

Scanty hair
Small breasts. Usg showed rudemintary uterus..what is the best
diagnostic test
1.FSH
2.Karyotyping
3.serum progesterone

Patient with Galactorrheia

What time to check serum prolactin
1.10 Am
2.after sexual intercourse
3.after nipple stimulation

Couples married for 3 years

All investigation normal including semen analysis and HSG
treatment
1.FSH
2i progesterone
3.clomiphine citrate
Least survival gynecological cancer
1.cervical
2.ovarian
3.vulval

Ultrasound picture of ovarian cyst 4.23cm×3.94cm simple cyst

Asymptomatic
Pt is 30 yrs old
1.repeat scan after 1 month
2.COCP
3.lapratomy

Conformation of androgen insensetivity syndrome

Pelvic x u s
Pelvic ct
Karyotype
Pitutary mri

Pregnant pt with irregular surface of uterus

A.increase incidence of antepartum hge
B.anemia with pregnancy
C.ocacionally obstructed labour

Old age patient with one episode of postmenoposal bleeding.she had

radical mastectomy 3 years ago taken tsmoxifen.what is the most
appropriate management
A.endometrial guided biopsy
B.endometrial thickness measurement

Pt with vulval cancer

Wide surgical excision done by separate incisions
What is the early complications of the procedure
1.wound breakdown
2.DVT

52 years old lady

Has chronic pelvic pain
Dysmenorrhea
Usg showed ovarian cyst and endometrial hyperplasia
1 . hystrectomy
2.depo progesterone
3.TAH BSO

Pt with PCO oligomenorhrea

Anovulation
What is the best dose of progesterone to oppose the action of
estrogen each month
1.14 days
2.21 days

What is the first lymph node group involved in vulval cancer

1.femoral
2.external iliac
3.inguina
Pt suffer from mild lower abd pain come to emergency room
complaining of mild lowe abd pain and vomiting 3 days ago.pic of us
clear seous cyst.most appropriate management:
A.ttt with anti inflammatory drug
B.immediate laparoscopy
C.follow up after 2 weeks

PG at 40 weeks
Presented in labour
Continuous uterine contractions FHR 180
Mild Vaginal bleeding
Diagnosis
1.rupture uterus
2.abruptu placentae

34 yrs old has 2 previous pap smears normal

The result is LISL most important next step
1.colposopy
2 . hystrectomy
3.HPV DNA test

Pregnant woman at 34 wks presented with sever vaginal bleeding.

.fetus IUFD
What is next step
1.cs
2.oxytocin
3.IV fluids + blood transfusion

Direct precursor of placental oestrogen

1.16-hydroxy-DHEAS
2 . cholesterol
3.Oesterone

38 weeks pregnant after ivf come to emergency room complaining of

mild abdominal pain. ‫ معاها صورة‬ctg ‫ت بيز‬-‫فيها ف‬
A.repeat test after 1 hour
B.immediate delivery
C. Fetal scalp ph
D.biophysical profile

a patient with secondary infertility with no history of PID or

endometriosis?
1) Chlamydial infection
2) Gonorrhea infection
3) Trichomonis vaginalis

Pregnant patient complaining of pruritis with no skin lesion ,normal

liver enzymes ,this condition treated by
.ursodeoxycholic acid
Cholestyramin
Estrogen

Indication of colposcopy
A.routine after cone biopsy
B. High grade squamous intraepithelial neoplasia in 27 years old
C.normal pap smear in patient with history of dysplasia
Pregnant female with cushing syndrome the outcome
Still birth
Preterm labor
Neonatal death
Conjenital malformations

Chromosomal anomaly causing ist trimestric abortion

Trisomy

percentage of tubal ectopic with one episodes of PID

a. 9%

percentage of tubal ectopic with 3 episodes of PID

70% ??

Incidence of tubal factor infertility after one attack of PID

12%
20%
30%
50%

*** The incidence of tubal infertility has been reported to be:

- Approximately 12% after one episode of PID
- Approximately 23% after two episodes of PID
- Approximately 53% after three episodes of PID

In pregnant 16 weeks ms alfa fetoptn.is 0.02 multiple of the media it

help in diagnosis of wt.
Anencephaly
Omphalocele
Down
Encephalocele

**** in down alfa feto protein below normal

time of prediction of antigen D in erythrocyte of fetus

A.5 weeks
B.8 wks
C.10 wks
***In the fetus, Rh antigens are expressed on RBCs from the 6-week conceptus

Intra operative there was couvelare uterus

What is the next step after delivery of the baby
1 . hystrectomy
2.suter the uterine incision and observations
3. Internal iliac artery ligation

Female with CIN type 2.cryocautery has been done.investigation by

cytology will be done after:
a-3 months
b-6 months
c- 9 months
d-1 year
Pt with anenecphaly fetus..what is the best management in
subsequent pregnancies
1.Maternal serum alfa feta protein
2.Amniocentesis
3.folic acid preconceptions

What of next increase worsens of endometriosis pathology

Late menarch
Multiple births
Prolonged lactational intervals
Mullerian duct anomalies

17 yrs old Presented with Hirsutism

1.Granulosa cell tumor
2.Arrhenoblastoma
3.hilus tumors

**** Arrhenoblastoma pt present with acne ,deep voice and

hirsutism

Osteoporosis checked for osteoporosis every:

A: 6 month
B: 9 month
C: 12 month
D: 24 month

Female 18 yrs old, primary amenorrhea,On exam :well developped

breast but no pubic or axillary hair.US: blind vagina. The most
important management is:
a-gonadectomy
b-estrogen therapy
c-creation of a new vagina

Concerning loop electro surgical excision than cervical conization:

a-more expensive than conization
b-need general anaesthesia
c-must to be done in operation room
d-cost effective

**** local anaesthesia, done in office.

Investigation for female showing powder burnt lesion in

ovary,douglus pouch.peritoneum….(in patient which are prepared to
pelvic surgery in gyne)the result is:
a-2%
b-less than 5%
c- 25%

which of the following ass with long term use of birth control pills
A.amenorreha
B.HTN
C.DM
D. thrombo embolism
E. Myochardial infaction

The cause of high mortality in pregnant women

A syphilis
B toxoplasmosis
C pheochromocytoma

nulligravida at 8 weak gestational age, follow up for genetic

screening, she refused the invasive procedure but she agree for once
screening , what is the appropriate action now:
a. do ultrasound
b. 1st trimester screening
c. 2nd screening
d. 3rd screening
e. Amniocentesis

Toxoplasma with pregnant female

a-high IgG increase the risk
b-vertical transmission increase in the 1st trimester
c- if acqured infection in the 1st trimester ; high risk of congenital anomalies
d-high risk of infection if you had previous baby with toxoplasmosis

Female with CIN type 2.cryocautery has been done.investigation by

cytology will be done after:
a-3 months
b-6 months
c- 9 months
d-1 year

Scenario for a female in labor.examination and CTG are

normal.according to health based advice:
a-enema upon admission
b-pubic hair shaving
c-rest on back

pregnant female with massive traumatic injury. Hypervolemia of

pregnancy lead to:
a-small amount of blood transfusion
b- small amount of colloid
c- hypervolemia lead to more blood loss. So need large volume for correction

Old age with postmenopausal bleeding. US:Endometrial

thickness=3mm. next step:
a-urgent D&C
b-investigation for FSH,LH,Estradiol

Mother coming with her newborn female that has vaginal bleeding
a-reassure the mother
b-do US for the newborn
c-gonadotrophin assay for the newborn

**** due to withdrawal of maternal hormones

Young female with 1ry infertility. Normal investigation for her and for
husband.clomide was used for one year .ttt:
a-Clomide and IUI
b-IUI
c-IVF
Pregnant female with strict vegetable diet. Deficiency of:
a-vit b12
b-folic acid
c-ca

Pregnant female –by US>>posterior wall placenta and anterior

subserus fibroid measuring about 6*8cm,the risk is
a-obstructed labor
b-fetalmal presentation
c-placental abruption
d-increas risk of PPH

A pregnant female develops lesions on the vulva and vagina and she
was diagnosed as genital herpes, what should be included in her
future health care?
a. Cesarian section should be done if the lesions did not disappear before 2 weeks of
delivery date
b. Oral acyclovir to treat herpes
c. Termination of pregnancy because of the risk of fetal malformations
d. Avoidance of sexual intercourse for 1 month after the healing of the lesions

(Picture of US showing outline of fetal head and posterior wall

placenta reaching the internal os and completely cover it) female with
3 months from LMP with abdominal pain and vaginal bleeding . US as
shown in the picture. Ttt:
a-progesterone
b- bed rest
c-termination of pregnancy

Pregnant woman with suspected DVT , what is the best initial

investigations :
A. Duplex US .
B. D dimer .
C. Platysomgraphy .
D. Venogram

****Duplex US = comprsion US

a patient with secondary infertility with no history of PID or

endometriosis?
1) Chlamydial infection
2) Gonorrhea infection
3) Trichomonis vaginalis

HPV 16 and 18 in relation to cancer cervix in :

1) 25%
2) 50%
3) 80%
4) 99%
 screening of female by HPV and cancer cervix was negative so
rescreen after:
1) 6 months
2) 1 year
3) 2years
4) 3years

Prostaglandin all true except

1) Inhibition of cycloxygenase enzyme
2) Patenet ductus arteriosis closure
3) All have the same physiological action
4) Vasodilators

treatment of ectopic pregnancy all except ?

a. Salpinectomy
b. Salpingo-ophorectomy
c. Linear salpingostomy
d. Milking of the tube if it is near to the fimbrial end
e. Segmental removal of part of the tube

After major pelvic operation.observation:

a-absent intestinal sound is due to intestinal obstruction
b-high fever in the first day need antibiotic(I can remember that it was oral antibiotic)
c-obesity may cause wound infection

Most common complication of abdominal hysterectomy?

Infectious complications after hysterectomy are most common, ranging from

10.5% for abdominal hysterectomy to 13.0% for vaginal hysterectomy and 9.0% for
laparoscopic hysterectomy.

Female with recently inserted IUCD coming with watery brownish

vaginal discharge & abdominal pain what is the most likely Dx :
a. Uterine rupture
b. Ovarian torsion
c. Bacterial vaginosis
d. Ectopic pregnancy

Pregnant 37 weeks with vaginal discharge.the cause was

streptococcal organism. Management:
a-penecillin G after delivery
b-start antibiotic ttt
c-CS
d-wait for symptoms

Chance for spontaneous abortion in patient had use gonadotropins(

or gonadotropin releasing hormone ) compairing with patient with
normal pregnancy is
a-higher
b-lower
c-the same
d-neglected

Alfa feto protein Marker of:

A.Dysgerminoa
B.Blastoma
C.Endodermal sinus tumor
exclusion of ectopic pregnancy is supported by:
a.negative urine for HCG
b. negative serum for B HCG sub unit
c. cludocenteises reveal un clotted blood
d. abscnets of intra utrin sac at 6 wks on pelvic U/S

woman in therties or forties present with abnormal utrine bleeding.. the

most acurrate prosedure for diagnosis is:
a. endometrial biopsy
b. D&C
c. hystroscopy
d. hormonal therapy

Pregnant woman with symptoms of hyperthyroidism ,

TSH low :
a- Propylthyiouracil
b- Radio-active iodine
c- Partial thyroidectomy

50y female with breast cancer and CA125 elevate.

So elevation due to
a-breast cancer
b-associate with ovarian cancer
c-due to old age
d-normal variation
The correct answer is a , beause this pt. high risk
of breast cancer.
- CA125 is a tumor marker mostly used for
ovarian Ca, but it's also used with endometrial,
fallopian, breast, & GIT Ca

female after sexual attack on exam hymen tear in

a-2 o'clock
"""""""b-4
""""""c-6
""""""""d-8
tear appear between 5 and 7 o'clock-

pregnant lady 16 wks presented with vaginal bleeding

,enlarged abdomen,vomiting ,her uterus is smaller
than expected for the gestational age,BhCG 80,U/S
snowstorm appearance,diagnosis:
a. complete hydatiform mole
b. partial hydatiform mole

Treatment of Chlamydia with pregnancy:

 a. Azithromycin
b. Erythromycin base
For treatment of chlamydia during pregnancy, the CDC
recommends: -
erythromycin base, 500 mg orally, four times a day for
seven days; or amoxicillin (Amoxil), 500 mg, three times
a day for seven days.
Alternatives include:
-
Erythromycin base 250 mg, four times a day for 14 days;

obese female, insulin resistance and hairstisim so

diagnosis
a-poly cystic ovary
b-hyperprolctinmia
c-familial
Girl with amenorrhea for many months . BMI is 20
and is stable over last 5 years . diagnosis
a.Eating disorder
b.Pituitary adenoma
BMI 20 == under weight*******

Old female with itching of vulva , by examination

there is pale and thin vagina , no discharge . what is
management
a. Estrogen cream
b. Corticosteroid cream
c. Fluconazole
48 years old with irregular menses presented with
fatigue and no menstruation for 3 months with
increased pigmentation around the vaginal area with
no other symptoms. ur next step would be
d. reassure the patient
e. do a pregnancy test
f. do ultrasound
In 24 years para one experienced postpartum hge and undergo evacuation and
curettage
Then she comes to the clinic copmplain of 2ry infertility
Laparoscobic inttrauterine adhesiolysis done
Then you will advise her to take
a.2.5 mg estrogen only for 2w
b.2.5 mg estrogen and progesteron
c.1.5 estrogen and progesteron

What is the first lymph node group involved in vulval cancer

1.femoral
2.external iliac
3.inguinal

Pregnant woman at 34 wks presented with sever vaginal bleeding. .fetus IUFD
What is next step
 1.cs
2.oxytocin
3.IV fluids + blood transfusion

PG at 40 weeks
Presented in labour
Continuous uterine contractions FHR 180
Mild Vaginal bleeding
Diagnosis
1.rupture uterus
2.abruptu placentae

Pt suffer from mild lower abd pain come to emergency room complaining of mild lowe abd
pain and vomiting 3 days ago.pic of us clear seous cyst.most appropriate management:
A.ttt with anti inflammatory drug
B.immediate laparoscopy
C.follow up after 2 weeks
If there is fever A

If pt with sever pain B

17 yrs old Presented with Hirsutism
1.Granulosa cell tumor
2.Arrhenoblastoma
3.hilus tumors
Arrhenoblastoma is tumor secreating androgen**.

52 years old lady

Has chronic pelvic pain
Dysmenorrhea
Usg showed ovarian cyst and endometrial hyperplasia
1 . hystrectomy
2.depo progesterone
3.TAH-BSO

Pt with vulval cancer

Wide surgical excision done by separate incisions
What is the early complications of the procedure
1.wound breakdown
2.DVT
Pt is 30 yrs old ..Ultrasound picture of ovarian cyst 4.23cm×3.94cm simple cyst
Asymptomatic
1.repeat scan after 1 month
2.COCP
3.lapratomy
Pregnant female with cushing syndrome the outcome
Still birth
Preterm labor
Neonatal death
Conjenital malformations
Indication of colposcopy
A.routine after cone biopsy
B. High grade squamous intraepithelial neoplasia in 27 years old
C.normal pap smear in patient with history of dysplasia
Old age patient with one episode of postmenoposal bleeding.she had radical mastectomy 3
years ago taken tsmoxifen.what is the most appropriate management
A.endometrial guided biopsy
B.endometrial thickness measurement
Pregnant pt with irregular surface of uterus
A.increase incidence of antepartum hge
B.anemia with pregnancy
C.ocacionally obstructed labour
Alkylating agent
1.vincristne
2.chlorambucil
3.methotrexate
Causative organism of toxic shock syndrome
Staph. Aureus.1
B.hemolytiv streptococci.2
Hcg
1.secreted by decidua
2.maintain integrity of corpus luteum
3.peak level at term
Conformation of androgen insensetivity syndrome
1.Pelvic x u s
2.Pelvic ct
3.Karyotype
4.Pitutary mri
 Least survival gynecological cancer
cervical.1
ovarian.2
vulval.3
yrs old Presented with amenorrhea 18
Scanty hair
Small breasts. Usg showed rudemintary uterus..what is the best diagnostic test
FSH.1
Karyotyping.2
serum progesterone.3
Best diagnostic test for post menopausal bone density
1.MRI
2.Dual EXA
When clomiphene citrate will fail
Low weight,1
Hyperandrogenism.2
Unexplained infertility.3
Anovulation.4
Pregnant pt suffering from itching in the body particularly sole and hand specially at night.the
most specific diagnostic test?
A.bilirubin
B.bile acid
C.alkaline transaminase
D.gumma glutamyl transpeptydase
Patient with Galactorrheia
What time to check serum prolactin
1.10 Am
2.after sexual intercourse
3.after nipple stimulation
Direct precursor of placental oestrogen
OH-DHEAS-1.16
cholesterol . 2
Oesterone.3
35 weeks PG came for regular antenatal folow up Usg revealed oligohydrimnnios most likely
cause
1.dudenal atresia of baby
2.DM
3.P PROM
Pt on cocp present because she was missed to take her pill in the same morning
What you will advice
Take the missing pill immediatly and continue pills.1
2.emergency contraceptive
3.iucd
4.D&C
Postmenopausal lady with lichen sclerosus
What is the treatment
a.cobetasol 0.05%
female 18 month infertilty
laparscopy gun shot lesion+adhesionin ovarian fossa after ablasion
timed ilntercourse
a.iui
b.ivf
c.clomid

70 yrs old
Presented with post menopausal bleeding cervix healthy
Most likely cause :
atrophic vaginitis
38 weeks patient with come to emegency room complaining of mild vaginal bleeding the fetus
vertex with ‫ معاها صوره فيها‬sinusoidal rhythm
a.Immediate c.s.
b.Repeat ctg
c.Fetal blood ph
Obese patient with rabid progressive hirsutism
Fsh normal
Lh. Normal
Testosteron 500 lncreased
Bp bl.suger normal
A.androgen secreting tumor
B.PCO
c.gonadal origin.

.Case of precauscious puperty

Caudal brain image normal
Normal bone age
;;Commonest cause
a.Idiopathic
b.Cerebellar
38 weeks pregnant after ivf come to emergency room complaining of mild abdominal pain.
‫ معاها صورة‬ctg ‫ت بيز‬0‫فيها ف‬
 A.repeat test after 1 hour
B.immediate delivery
C. Fetal scalp ph
D.biophysical profile
Incidence of tubal factor infertility after one attack of PID
a.12%
b.20%
c.30%
d.50%
:The incidence of tubal infertility has been reported to be ****
Approximately 12% after one episode of PID -
Approximately 23% after two episodes of PID -
Approximately 53% after three episodes of PID -

Pregnant patient complaining of pruritis with no skin lesion ,normal liver enzymes ,this
condition treated by
.a.ursodeoxycholic acid
b.Cholestyramin
c,Estrogen
Acase of 28 week pregnant complain of pruritis with no skin lesion sever symptoms
Elevated liver enzymes
Elavated direct billirubin
Normal indirect billirubin
This case will deliver at
35_34
38_37
40_39
41_40
wks missed abortion 12
a- misoprstol
b- PGF2
C-OXYTOCIN
pic of laproscopy with bloody lesions on the surface
of the uterus seems to be endometriosis, next to it a
picture while treating these lesions
Question is this procedure is done because of ?
a.Pelvic pain
b.Infection
Girl with headache. PRL 435
Wt. Nxt to do
MRI
Dopamine agonist
Female complaining of regular cyclic abdominal pain.on examination appearance of secondry
sexual characters.on examination there is normal hymen but cannot completely indrntified the
vagina.cause
A.cribtiform hymen
B.longitudinal vaginal septum
C.sptate vagina
D.transverse vaginsl septum
?The most common chromosomal anomalies in aborted fetus
A.autosomal triosmy
B.triploidy

C.tetraploidy
Pt with gestational DM.she checked her glucose level four times per day.she complaining that
glucose level very high after breakfast even after normal fasting glucose level.cause
A.eating heavy meals at night
B.increased induline resistance in the morning
yrs woman nullipara wants to get pregnant came for prenatal counseling , fsh , lh and all 42
hormones were normal and she has no complain
: Your advice is
a.Reassure her
b,IVF
c,IUI
Alpfa feto protin icrease in all except:
a.Down
b.Anencephaly
c.Omphalocele
d.Encephalocele

Intial dose of thyroxine in pregnant with hypothyroidism

A.0.5 mg/kg
B.1.5 mg/kg
C.2 mg/ kg
D.2.5 mg/kg
Obese patient have pco complaining of irregular infrequent vaginal bleeding.most appropriate
management
A.endometrial guided biopsy
B.endometrial thickness measuremen
Biopysical profile:
AFI 15
One extension with flexion of limb
Ine fetal breathing movement
One discrite body movement
Reactive non stress test
A.4
B.6
C.8
Pregnant female with doppler indicating fetal anemia
A.repeat doppler after 1 week
B.rrpeat after 2 week
C.repeat after 3 week
Most common cause of acute PID
A.after insertion of IUD
B.unprotected sexual intercourse
The most common cause of secondry dysmenorrhea
A.endometriosis
B.IUD
Pregnant with upper respiratory tract infection.risk of devolping unintended pregnancy
A.rifampicin
B.doxycycline
**** Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of
conception
b drug is teratogenic so termination after that is essential
Decreased prolactin level in
A.dopamine
B.serotinin
C.thiazide

​Which of the following is most approperiet management of toxic shock

syndrome
a.antibiotic
b.D&C
c. Hysterectomy
d.vaginal sulfonamide cream

Cause of symetrical IUGR

A.maternal cause
B.chromosomal anomalies
Old age pt with uterine prolapse and wide hiatus and weak levator
ani.what to do for prevention of failure of procedure
A.pelvic floor excercise
B.local estrogen
Pt with anenecphaly fetus..what is the best management in subsequent
pregnancies
Maternal serum alfa feta protein.1
Amniocentesis.2
folic acid preconceptions.3
Intra operative there was couvelare uterus
What is the next step after delivery of the baby
1 . hystrectomy
2.suter the uterine incision and observations
3. Internal iliac artery ligation
couvelare uterus ass with high risk of PPH ****
PG at 40 weeks Presented in labour
CTG is OK. .cervix fully dilated. .vertex at +1 station
What you will tell pt about advantage of episiotomy? ?
1.rarely extend to rectum
2.less blood loss
3.protect against perineum damages
In pregnant 16 weeks ms alfa fetoptn.is 0.02 multiple of the media it help
in diagnosis of what?.
a.Anencephaly
b.Omphalocele
c.Down
d.Encephalocele
**** A typical normal range is 0.5 to 2.0 or 2.5 MoM.

• MSAFP above normal is seen in multiple

gestation, when there is placental abruption, as
well as in a number of fetal abnormalities, such
as neural tube defects including spina
bifida andanencephaly, and abdominal wall
defects. Other possibility is error in the date of
the gestation.
• MSAFP below normal is associated with a

smaller number of conditions, including Down

syndrome and Trisomy 18. Diabetic patients
also have lower levels.
Pregnant female with cushing syndrome the outcome
a.Still birth
b.Preterm labor
c.Neonatal death
d.Conjenital malformations
Indication of colposcopy
A.routine after cone biopsy
B. High grade squamous intraepithelial neoplasia in 27 years old
C.normal pap smear in patient with history of dysplasia
What anti epileptic drugs associated with impaired cognitive functions
of baby at 3 years old
Sodium valporate .1
phenytoin.2
carbemazepine.3
Alkylating agent
vincristne.1
chlorambucil.2
methotrexate.3
Couples married for 3 years
All investigation normal including semen analysis and HSG
treatment
FSH.1
2i progesterone
clomiphine citrate.3
34 yrs old has 2 previous pap smears normal
The result is LISL most important next step
1.colposopy
2 . hystrectomy
3.HPV DNA test
HBV test first then colposcopy ‫زم‬# ****
:Osteoporosis checked for osteoporosis every
A: 6 month
B: 9 month
C: 12 month
D: 24 month
pregnant woman with UTI which is the best antibiotics to be given if she
?has no allergy
A.nitrofurantoin
B.ampicillin
C.sulfatrimethoprim
D.tetracyclin
E.aminoglycoside
What of next increase worsens of endometriosis pathology?
Late menarch
Multiple births
Prolonged lactational intervals
Mullerian duct anomalies
Q about the anaphylactic shock
a.ttt by epinephren
b.type 2 hypersensitivity reaction
c.result from degranulation of natural killer cells
:Biopysical profile
AFI 15
One extension with flexion of limb
Ine fetal breathing movement
One discrite body movement
Reactive non stress test
 A.4
B.6
C.8

Biophysical Profile Score (BPS or BPP)

The biophysical profile score is a method used to asses the well being of a fetus at increased
risk for death or damage in utero. The biophysical profile score evaluates the fetus for the
presence of five biophysical parameters using ultrasound and an electronic fetal heart rate
monitor. A score of 2 points is given for each parameter that meets criteria. The test is
continued until all criteria are met or 30 minutes have elapsed. The points are then added for
a maximum score of 10.

Component Normal (2 points) Abnormal (0 points)

No episodes of fetal breathing movements
Fetal Breathing One or more episodes of fetal breathing
lasting at least 30 seconds during a 30 minute
Movements lasting at least 30 seconds within 30 minutes.
period of observation.

Gross Body 3 or more discrete body or limb movements Less than 3 body or limb movements in 30
Movement within 30 minutes minutes

One or more episodes of active extension and Slow extension with no return or slow return
Fetal Tone flexion of a fetal extremity OR opening and to flexion of a fetal extremity OR no fetal
closing of the hand within 30 minutes movement

A single deepest vertical pocket of amniotic

Amniotic Fluid A single deepest vertical pocket of amniotic
fluid measures greater than 2 centimeters. is
Volume * fluid measures 2 centimeters or less
present

Non-stress test
Reactive Nonreactive
(NST)**

A total score of 8 or 10 is normal, a score of 6 is

considered equivocal, and a score of 4 or less is
abnormal
American college of obestetric and gynecology recommend for
prevention of occurance of preterm labour
A..screening of bacterial vaginosis even in asymtomatic women
B..screening of fetal fibrinoctin even in aymptomatic women
48 YR old pt having hysterectomy , after which she complaints of
unwanted urine leakage from the vagina the cause?
a)uretro vaginal fistula
b)vesico vaginal fistula
c)Urethro vaginal fistula
What is the serious symptom in pregnancy:
a- Abdominal pain
b- Back pain
c- Leg swelling
d-Hyperacidity
:Clomid not used in
A.idiopathic infertility
B.unknown infertility
C hyperandrogism
D.underweight
female G3P3 post-partum 4wk treated for 3days with antibiotic ( I forget
it) for PID but no response & she still febrial , O/E by PV you found a
10cm mass in the sac between the vagina & the rectum, tender,
fluctuating what will be your action:
a- Colpotomy
b- Laparotomy
c- Laparoscopy
d- D/C antibiotic & start another one
cx cancer staging ass with
a.IVP " Intra venous pyelography"
b.Lympho..
c.Cystoscope
d.Sigmoidoscopy
The most common site for rupture of ectopic pregnancy?
A.ampulla
B.isthmus
C.fimbria
?The most common site of ectopic pregnancy
A.ampulla
B.isthmus
C.fimbria
what is the ovulatory disorder percentage in cases of infertility???
a.10%
b.15%
c.25%
d.50%
OCP that causes hyperkalemia
 A.Drospirenone
RNA virus
A.rubella
B.hepatitis
C.varicella
D.Hpv
pregnant pt p2 in 38ws come with iufd and induction of labour by
oxytocin was done for 12hr but no changes in cx what will u do???
a.come after 1 w
b.intracervical pG gel
c.cs
d.estimate the fetal wt by us

In chlamedia infection ttt is ? ( not mention pregnant or not )

Doxcycline
Azithromycine
Metroniadizole
.Non-pregnant:azithromycin-doxycycline. Pregnant:erythromycin ***
pregnant lady with cystitis , one of the following drugs
.contraindicated in her case : imp
Amoxicillin

Ceftriaxone
Flouroquiolone
female pt. with typical presentation of trichomons , ttt :
Metronidazole
classical case of candidal infection → itching , white discharge from
: vagina , ttt is
A.Miconazole
B.Amoxicillin

<<< Pt with history of infertility the first line of investigation for this couple is
semen analysis
Female came with hx of sever abdominal pain, vaginal bleeding for 6 hours, -
amenorrhea for 8 wk, , O/E tachycardiac, hypertensive, tense abdomen. what is
:the most likely site of the ectopic pregnancy
a- Fallopian tube
b- Ovary
c- Peritoneum
d- Fimbria
Pt with dysmenorria, infertility, not responding to naproxen, what cauld be the
:cause
a- Endometritis
b- Endometriosis
female with vaginal bleeding , abdominal pain : first Inx :
US
Vaginal Examination
Acanthosis Nigricans associated with :
polycystic ovary syndrome
**(due to insulin resistant)

the average menstrual cycle is

 28 days
pregnant lady 28 wks with chlamyda infection :
azithromycin
erythromycin or amoxicillin.
(doxcyline(non pregnant
Condition not associated with increase alpha feto protein
▪ Breech presentation
▪ Down syndrome
▪ Gastroschisis
**Down syndrom have below normal AFP
Female pt around 35 years old, hx of thromboembolic disease, what type of
.reversible contraceptive she can use imp
• OCP
• IUCD
• Mini pills

<< Best anti HTN in pregnancy

hydralazine
methyldopa
** is the first line in treatment of pregnancy
True about DUB >>
can occure in adolescent girls
A pregnant woman, multigravida, 38 weeks gestational age presented with
glucosuria. Gestational diabetes was confirmed by glucose tolerance test. The
:next step is
a) Repeat Glucose tolerance test
b) Cesarean section
c) Diet adjustment
d) Start sliding scale insulin

Elderly female married since 30 years had fever, chills, dysurea, and
:diarrhea. No back pain. The diagnosis is
a) Acute bacterial cystitis
b) Acute pyelonephritis >>In acute
pyelonephritis, the classic triad of fever,
costovertebral angle pain, and nausea and/or
vomiting may be present, although they may not
.necessarily occur together temporally
c) Bacterial gastroenteritis
d) Viral gastroenteritis
Uterovaginal prolapse:
a) Increase heaviness in erect position (correct)
b) More in blacks
c) A common cause of infertility
Pregnant women G4P3+1 on GA 10 wk came to you with IUCD
inserted & the string is out from O.S what is the most important
: measure
a- leave the IUCD & give A.B
b- leave the IUCD & send to Ob/ Gynaecologist to
remove
c- leave the IUCD
 .d- do laparoscopy to see if there is ectopic preg
e- Reassurance the pt
: Placenta previa excludes-30
a- Pain less vaginal bleeding
(b- Tone increased of uterus (correct
c- Lower segmental abnormality
d- Early 3rd trimester
Pregnancy test +ve after :
a- a-one day post coital
b- 10 day after loss
menstrual cycle
(correct)>>qualitative
hCG test .Doctors
often order these tests
to confirm pregnancy as
early as 10 days after a
missed period
c- One wk after loss
menstrual cycle
What is the condition that produces malodorous watery vaginal discharge with
+ve clue cells in wet mount preparation slides:
a. Bacterial vaginosis
b. Vaginal Candidiasis
c. Trichomonas vaginalis
d. Gonorrhea
classical characteristic for genital herpes.Painful ulcers & vesicles

most common vaginal bleeding :

a. cervical polyps
b. menstruationonly with these MCQs , the correct
answer is b
twins one male and other female . his father notice that femle become puberty before
male so what you say to father

a. female enter puberty 1-2 year before male

b. female enter puberty 2-3 year before male
c. female enter puberty at the same age male
female after vaginal hesterectomy she complain of
:urin come from vagina………dx
a. Vesicovaginal fistula
b. Urethrovaginal fistula
c. Ureterovaginal fistula

The absolute contraindication of breastfeeding is :

a. Asymptomatic HIV patient
 b. Active hepatitis C
c. Pulmonary TB on treatment 3 months
Absolute contraindication of breastfeeding :
1-Infants with galactosemia.
2-Mothers who use illegal drugs.
3-Mothers infected with HIV, human T-cell lymphotropic virus type I or type
II, or who have an active herpes lesion on the breast.
4-Mothers taking any of the following medications: radioactive isotopes,
cancer chemotherapy agents, such as antimetabolites

48year old female lost her menstruation for 2

cycles, the method of contraception is condom,
examination was normal except for dusky
discoloration of the cervix. What u will do next:
a.Progesterone challenge. b.Beta HCG. c.Pelvic
u/s
The correct answer is b

Pregnant women has fibroid with of the following is

True:
a.Presented with severe anemia
b.
Likely to regress after Pregnancy
c.
Surgery immediately
d.
Presented with Antepartum He
the correct answer is b
Fibroids may also be the result of hormones.
Reproductive hormones like estrogen and
progesterone can stimulate cell growth, causing
fibroids to form. During pregnancy, your influx of
hormones may cause your fibroids to grow in size.
After pregnancy and during menopause most
fibroids begin to shrink, due to a lack of hormones

A pregnant lady came to you to screen her fetus for

down syndrome, what is the best method:a.
Amniocentesis. + Karyotyping
b.Choriocentesis. ​the correct answer is a

cyclic menstruation that increase in frequency:a.

Polymenorrhea.b. Hypermenorrhea.c. Menorrhagia.d.
Dysmenorrhea. ​

The correct answer is a

Polymenorrhea : frequent menestration ( < 21 day cycle
)
Hypermenorrhea or menorrhagia : abnormally heavy
and prolonged menstrual period at regular intervals .
more than 80 ml of blood loss per cycle or prolonged
bleeding , more than 8 days.
Oligomenorrhea : increase length of time between
menses ( 35-90 days b\w cycle)
Metrorrhagia : bleeding bwteen period.
Menometrorrhagia : exessive and irreglar bleeding.

45 year old female complaining of itching in genitalia for certain period, a

febrile, -ve PMH, living happily with here husband since 20 year ago on
examination no abdominal tenderness , erythema on lower vagina , mild Gray
discharge no hx of UTI . pyleonephritis
Most probable diagnosis:
a- Vaginitis (correct)
b- Cystitis
c- CA of vagina
d- Urithritis ( non gonococal

Common Types of Vaginitis

Disorder Typical Symptoms and Signs Criteria for Diagnosis Microscopic Findings Differential Diagnosis
Bacterial vaginosis Gray, thin, fishy- Three of the Clue cells, decreased Trichomonal
smelling discharge, following: Gray lactobacilli, increased vaginitis
often with pruritus and discharge, pH coccobacilli
irritation; no > 4.5, fishy odor,
dyspareunia and clue cells
Candidal vaginitis Thick, white discharge; Typical discharge, Budding yeast, Contact irritant or
vaginal and sometimes pH < 4.5, and pseudohyphae, or allergic vulvitis
vulvar pruritus with or microscopic mycelia; best Chemical irritation
without burning, findings* examined with 10% Vulvodynia
irritation, or K hydroxide diluent
dyspareunia
Trichomonal Profuse, malodorous, Identification of Motile, flagellated Bacterial vaginosis
vaginitis yellow-green causative protozoa, increased Inflammatory
discharge; dysuria; organism by PMNs vaginitis
dyspareunia; erythema microscopy*
(occasionally by
culture)
Inflammatory Purulent discharge, pH > 6, negative Increased PMNs, Erosive lichen
vaginitis vaginal dryness and whiff test, and parabasal cells, and planus
thinning, dyspareunia, characteristic cocci; decreased
dysuria; usually in microscopy bacilli
postmenopausal findings
women
*Culture is needed if microscopic findings are negative or symptoms persist.

Femal patient came with lower abdominal pain, fever

on exam patient has lower abdominal tenderness and
tender cervical fornix, the most appropriate way to
diagnose the problem is:
a.Laparoscopy
b.Heterosalpingography
c.Abdominal CT
d.Radionuclar Study
femal about 30y c/o abdominal pain related to menses
(scenario going with endometriosis)…………next step
:in dx
a. Laparoscopy
b. U/S
c. CT
 Confirm diagnosis by laparoscopy , US & MRI
can use but if normal can not exclude
endometriosis .

Which of the following can lead to polyhydrmnios :

A. Duodenal atresia .
B. Renal agenesis . à Oligohydramnios
C. Post term pregnancy . àOligohydramnios
D. Diabetes inspidious .

A very very long scenario about a female patient with vaginal discharge
“malodorous watery in character” with pH of 6 & +ve clue cells but there is no
branching pseudohyphe. (He is telling you the diagnosis is vaginosis & there is no
fungal infection) Then he asks about which of the following drug regimens
should NOT be used in this paitent:
a. Metronidazole (PO 500 gm for 7 days)
b. Metronidazole (PO 2 large dose tablets for 1
or 2 days)
c. Metronidazole (IV or IM …..)
d. Miconazole ( PO …..)
e. Clindamycin (PO …..)

This case is " bacteria vaginosis" and

treatment by : metradinazole or clindamycine .
avoid miconazole because it is antifungal

14 years old girl complaining of painless vaginal

bleeding for 2-4 days every 3Weeks to 2 months
ranging from spotting to 2 packs per day; she had
2ry sexual ccc 1 year ago and had her menstruation
since 6 months on clinical examination she is
normal sexual ccc, normal pelvic exam appropriate
action
a. OCP can be used
b. You should ask for FSH and prolactin level
c. Don’t do anything & explain this is normal
A young female patient who is an office worker presented with itching in
the vagina associated with the greenish-yellowish vaginal discharge.
:Examination revealed red spots on the cervix. The diagnosis is
a) Trichomoniasis (correct)Women with
trichomoniasis frequently report a frothy
 yellowish-green vaginal discharge
b) Candidiasis>>whitish or whitish-gray
cottage cheese-like discharge
c) Gonorrhea
d) Gardnerella vaginalis
20 year lady come to ER with Hx of Rt sever lower abdominal pain with Hx of
amenorrhea for about 6 wk the most serious diagnosis of your deff. Diagnosis
could reach by:
a- CBC
b- ESR
c- U/S of the pelvis (ectopic pregnancy) (correct)
d- Plain X-ray
e- Vaginal swab for C/S
signs of androgen excess and ovarian mass , most likely tuner :
Sertoli-Leydig cell tumour (correct)
a 34 yr old divorced lady complains of 15 months amnorrhea , FSH
very high , Dx :
Pregnancy
ovulation
Premature ovarian failure
Hypothalamic lesion
Pituatary microadenoma
All causes hyperprolactenemia, EXCEPT:
pregnancy
acromegaly
methyldopa
allopurinol
Hypothyroidism
after delivery start breast feeding :-
as soon as possible
8 hrs
24 hrs
hrs 36
48 hrs
obstructed labor, which is true:
common in primi
excessive caput & molding are common signs
most common occipto- ant
can not be expected before labor
60 Y/O lady on OCP 21 days a month having recurrent vaginal
bleeding(spotting) after the stop of estrogen, best Tx:
a-endometrial Bx.
b-papsmear of the cervix.
c-add progestone .
d-stop estrogen.
e-abdominal US or laproscope.
-most common site of gonococcus infection in females in:
a-cervix.
.b-posterior fornix
c-urethra.
-post D&C the most common site of perforation is the:
a-fundus
b-ant.wall of the corpus
c-post. Wall of the corpus.
d-lat.wall of the corpus.
 e-cervix.
its c/I to stop preterm delivery in the following
condition:
a-aminochoronitis.
b-placental abruption.
c-preeclampsia.
d-A&B.
PPH happens more commonly with:
(a-multiple pregnancies.(due to increased risk of uterine atony
b-anemia.
c-preterm delivery.
d-antithrombin iii deficiency.
Before you start instrumental delivery it is important to check if
: there is
.a-face presentation
b-CPD
c-breech presentation.
d-cord prolapse.
in occipitoposterior malpositioning of the fetal head ,all of the-
:following are true except
.a-10% of all vertex deliveries
b-it causes significant delay of labor duration compared to the anterior
.presentation
c-andriod pelvis is a predisposing factor.
d-flexion of the head helps the rotation to the ant. Position
- Pregnant Teacher in her 20th week reported 2 of
her student developed meningitis. Prophylactic
Treatment:

a) Observe for the sign of meningitis

b) Meningitis Polysaccharide vaccine
c) Ceftriaxone 500mg PO once
d) Cefuroxime 250 mg IM or IV once
e)Rifampicine 600 mg BD for 2 days
mastitis with lactation:
Cont. brest feeding
Female wants a temporary contraceptive method, which
?one is recommended by research
A) OCP
B) IUCD
effective ttt of mastalgia ?
a- Caffeine
b- OCP “ “
c- tamoxifen
d-danazol
A young primigravida, 35 weeks gestation, had BP of 140/90, headache,
proteinurea & lower limb edema. What is the best management: (dx
(preeclampsia
a) Oral labetolol
b) Diuretics
c) Low sodium diet
d) Immediate C.section
e) Admission & observation of feto-maternal condition
Which of the following suggestive of ovarian cyst rather than ascites in
:percussion
a.Dullness centrally & tympanic peripherally
b.Dullness peripherally &tympanic centrally
c.Dullness all over
Q about sub dermal implantable contraception:
a- Is has low compliance compared to OCP
b- More side effect
c- No local reaction
:the most common cause of 2dry amenorrhea with high FSH & LH is
a- Menopause
b- Pituitary adenoma
c- Pregnancy

Patient with idiopathic anovulation. What drug to give:

Clomiphene
Progesteron
LH
FSH
Description of PCOS. Mechanism of PCOS:
Androgen Excess
OCP:
a. Changes the cervical mucus
b. increase pre menstrual tension
c. Have a failure rate of 3 %

(action of ocp : ( from reconstruction

A - inhibition of estrogen then ovulation
B – inhibition of prolactin then ovulation
C--inhibition of mid cycle gonadotropin then ovulation

b. Pregnant lady in her 30 wks gestation diagnosed as

having swine flu. She has high grade fever and cough for
4 days and her RR= 25/min. what will you do for her:
c. Give her Tamiflu 75 mg BID for 5 days
d. Refer her to ER for admission
e. Give her antibiotics
f. Refer her to OBGY doctor

Lactational mastitis..Rx:
_ doxycycline
_ ciprofloxacin
_ ceftriaxon
_ gentamyecin
_ cephalexin
55y old female post menopausal need calcium daily to protect against
osteoprosis the daily intak?
a)200 gm
b)400 gm
c)1000 gm
d)1500 gm
1500 ‫ و حاجة مريضة سن اليأس‬1000 ‫حاجة الحامل‬
pergnant woman in 10 week,,,come looks very ill ,,,dehydrated..dry mouth...skin
very dry...vomiting..& nothing become stable in stomach(seems to be like
(hyperemsis gravidrum
which u suspect to see in urine analysis
a...glucose
b..ketone.......sure,,,,,
c..leucocyte
 d..protein
according to post partum bleeding mangment by using PG (hemabate)
which is relative contraindication
a..maternal HTN....
b..maternal asthma.
c..maternal diabetes
****Hemabate is (Carboprost Tromethamine)
56y old female with history of breast cancer what is the plan for protection from
?osteoprosis
a)estrogen replacement therapy
b)vit D &Ca
pregnant lady with hepatits, how to confirm dx :
a- ALP
B-SGOT
C-WBC
D-ESR
methyl-progesteron used for PPH what is contrindication :
a.Pregnant with asthma
b.Pregnant with hypertension
c.Pregnant with DM
patient came with cervical carcinoma next investigation :
-cone biopsy
- Direct biopsy
-pap smear
23 years old female with regular menses. On US, she has
a 7cm ovarian cyst. otherwise everything is normal. dx:
a. corpus luteum cyst
b.follicular cyst
c.teratoma
d.another cancer
young female complains of 6 weeks amenorrhea and history
of VP bleeding for many days and by laparoscopy the is free
fluid in douglas of pouch(I don't remember the exact NO.)
what is the most probable cause??

rupture ectopic pregnancy

Most benign cause of postmenopausal bleeding
Cervical polyp
Atrophic vaginitis
in normal puerperium..
A-leochia lasts for up to 4 weeks
B-the uterus can't be felt after the 1st
week in abdomen
C-epidural analgesia can cause urinary
retention
best test to detect age of gestation is
LMP-
.U.S-
I think it is LMP
paient complain of infirtility 6 year ago and sever pain with cycle (
dysmeanorhea) DX
Endometriosis
Pelvic congestion
 Endometritis
pregnant not vaccinated against measls and mumps and rublla .. She
exposed to rublla 3 day ago what you do
No treatment
Immunoglobin
Tell her no affected on her pregnancy if she take
the vaccine
pregnant with uterine fibroid , has no symptoms only abd. Pain , US showed
:live fetus ,,,,, What is the appropriate action to do
Myomectomy
Hysteroectomy
Pain management
Pregnancy termination
Pregnant women has fibroid with of the following is True:
a.Presented with severe anemia
b.Likely to regress after delivery
c.Surgery immediately
d. Presented with Antepartum Hemorrhage
Pt G3 P3 all her deliveries were normal except after the second one she did
D&C for retained placental parts, presented with amenorrhea after a period
of irregular cycle, labs all normal except : high FSH, high LH, low estrogen
:DX
a- Asherman syndrome
b- Ovarian failure
c- Sheehan syndrome
d- Turner
female G3P0 , c/o infertility , have regular non heavy cycle, trichomonus
infection treated at age of 17 , previous 3 elective D/C in first month gestation
:,DDx
​ ​- Asherman $
Shehan syndrom-
​ ​- Endometritis
Most Dangerouse sign during pregnancy?
Vaginal bleeding
perinatal mortality
A-include all stillbirth after the 20th wk of
pregnancy
B- include all neonatal deaths in the firist
8wk of life
c-in clude all stillbirth and firist wk of
neonatal deaths
d-is usually death per 10,000 live birth
:.the most common complication of C.S
1) Urinary bladder injury
2) Postoperative endometeritis
3) Aspiration pneumonia
4) D.V.T.
all of the following cosidered indication for C.S except
a. fetal destresed
b.carcinoma of insitue cx
c.genital herpes
d.proior urethropexy
B HCG level 160 adnexal mass 2-5 cm empty uterus
a-oral methotrexate
b- laparscopy
c- lapartomy
d- conservative
in cytology +ve pap smear mean
a.abnormal cell are present
b. malignant cell are present
c. moderate dyskaryotic cells or worse are present
d.mildy dyskariotic cells or worse are present
e. inflmmation and leukocyte are present
the most common ovarian tumor with pregnancy
a.leutinoma
b.theca leutin cyst
c.struma ovarii
*** if there is teratoma with choices select it ((The most common ovarin tumor with
pregnancy is bengin cystic teratoma))
Pregnant 37 weeks with vaginal discharge.the cause was streptococcal
organism. Management:
a-penecillin G after delivery
b-start antibiotic ttt
c-CS
d-wait for symptoms
American college of obestetric and gynecology recommend for
prevention of occurance of preterm labour
A..screening of bacterial vaginosis even in asymtomatic women
B..screening of fetal fibrinoctineven in asymtomatic women

which of the following test should be used in evaluation pt at risk for HIV
a. VEDRL
b. eastren plot analysis
c. enzyme linked immunoassy
d. gonozyme test
28yrs old women has cx cytology smear report many severaly dyskaryot
cells and few frankly malignant cell what next step in managment;
A.repeat smear
B. cone biopsy
C.hytrectomy
D.D&C
E.colposcopy & biopsy
B) after vaginal hysterectomy the patient came with vaginal
bleeding the next step:
1) Suturing of vaginal fornices
2) Packing of the vagina
3) Fill urinary bladder to exert positive pelvic pressure
4) Laparotomy and search the source of bleeding
C) most series complication of sterilization using monopolar
electrocoagulation
1) Haemorrhage from mesosalpinx
2) Burn to the skin
3) Electric injury to the intestine
4) Clamping the round ligament rather than the tubes
most complications of laparoscopy is all except?
1) Hypercapnia
2) Emphysema to the peritoneal skin
3) Injury to common iliac vessels
4) Injury to posterior division of lumbosacral plexeus
E) ARDS all except:
1) hypoxia and acidosis
2) cortisol increase phospholipid production
3) appear ground glass appearance
4) positive expiration may help in treatment
F) vulvar atrophic ulcer shiny with well demarcated edges with
excoriation :
1) lichen planus
2) lichen sclerosis etrophica
3) vulvar intraepithelial neoplasia

All are epithelial ovarian tumor except

1) Brenner
2) Mucinous adenocarcinoma
3) Endometriod tumor
4) Teratoma
5) Serous cystadenocarcinoma
**** Ovarian epithelial tumours are classified according to the following
histological subtypes:
• serous,
• mucinous,

• endometrioid,

• clear cell,

• Brenner,

• transitional cell,

• small cell,

• mixed mesodermal and

• undifferentiated.

under aerobic conditions the kreb's cycle is the main source of :

1) Glucose
2) Fatty acids
3) Proteins
4) ATP
***Krebs proposed a specific metabolic pathway within the cells to account
for the oxidation of the basic components of food – carbohydrates, protein and
fats – w for energy.
Prostaglandin all true except
1) Inhibition of cycloxygenase enzyme
2) Patenet ductus arteriosis closure
3) All have the same physiological action
4) Vasodilators
a patient at 16 weeks gestation have symmetrical growth retardation the cause is:
1) Diabeted mellitus
2) Chronic preeclampsia
3) Genetic causes

*** Chromosomal
rubell causes congenital anomaly at :
1) 6-8 weeks
2) 12-16 weeks
3) 20-23weeks
4) 25-32 weeks
*** Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant
woman who has contracted rubella, usually in the first trimester. If infection occurs 0–28 days
before conception, the infant has a 43% chance of being affected. If the infection occurs 0–12
weeks after conception, the chance increases to 51%. If the infection occurs 13–26 weeks
after conception, the chance is 23% of the infant being affected by the disease. Infants are
not generally affected if rubella is contracted during the third trimester, or 26–40 weeks after
conception.
L) A patient had ovulation induction with IUI
(intrauterine insemination) for 3 cycles the next step ?
1) Repeat one more cycle
2) Repeat two more cycle
3) ART
4) Repeat 3 more cycles
treatment of ectopic pregnancy all except ?
1) Salpinectomy
2) Salpingo-ophorectomy
3) Linear salpingostomy
4) Milking of the tube if it is near to the fimbrial
end
5) Segmental removal of part of the tube
a patient with secondary infertility with no history of PID or endometriosis?
1) Chlamydial infection
2) Gonorrhea infection
3) Trichomonis vaginalis
O) a patient has two first degree relatives the best is:
1) Prophylactic oophorectomy
2) Follow up
3) Screening by ultrasound and CA 125
screening of female by HPV and cancer cervix was negative so rescreen after:
1) 6 months
2) 1 year
3) 2years
4) 3years
Q) Marshall-Marshetti Krantz operation
R) a pap smear showed low grade intraepithelial
neoplasia with HPV infection so next step:
1) Antibiotics and repeat pap smear
2) Coposcopy
3) Cone biopsy
4) Radical hysterectomy
S) a lateral ventriculomegally of 14 mm width all will be
done except :
1) Whole body check up by sonogram
2) CT scan
the percentage of Ovarian causes of infertile couple ?
1) 10%
2) 15%
3) 20%
4) 25%
U) HPV 16 and 18 in relation to cancer cervix in :
 1) 25%
2) 50%
3) 80%
4) 99%
after radical hysterectomy catheter shouldm't be removed until the residual
volume is :
1) < 75 ml
2) 75-100 ml
3) 100-150 ml
4) 150-200 ml
after the delivery of full term fetus by pulling the cord a global mass descended
and blood pressure dropped to 70/40 so the best used in this condition:
1) Vaproate
2) Halothane
3) Nitrous oxide
4) Pantosal Na
***(( This is acase of Uterine inversion)) Halothane and
Nitroglycerine (100mcg to 200 mcg intravenously)have a higher success rate
patient with heart disease NIHA class 3 GA 32 weeks fully dilated and head on
perineum for 1 hour in occipito-anterior exhausted and unable to bear down, so
the next step :
1) C.S.
2) Use Ventouse
3) Use of Low forceps
4) Spontaneous delivery
which entitled in Fitz-Hugh Curtis syndrome:
1) Chlamydial infection
2) Gonorrhea
3) Candidiasis
4) Ovarian fibroma

❖ Maternal mortality ratio

❖ Anderostenoate and DHEA and testosterone in relation to hirsutism and
hyperandrogenism
❖ Placenta abruption
Powder burnt lesion in Douglas pouch,ovary,peritoneum …….can be seen in a
patient who is:
a-nulliparas